Medicare Enrolled
Dr. Robert Balbis, D.O.
Family Medicine · Lake City, FL
Practice pattern: Clinical Cardiology
— Primarily office-based clinical cardiology
High
DATA COVERAGE
Data in 3 of 4 federal sources
Measures public federal data availability — not provider quality
Informational, not a quality rating.
This page presents federal public records about Dr. Balbis from CMS (NPPES, Open Payments, Medicare Provider Utilization, PECOS). It is not medical advice, an endorsement, or a judgment of clinical quality. Always consult the provider directly and a licensed clinician for medical decisions. Read methodology →
Are you Dr. Balbis?
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What this data tells you about Dr. Balbis
Dr. Robert Balbis is a family medicine specialist in Lake City, FL, with 20 years of NPI registration. Based on federal Medicare data, Dr. Balbis performed 3,308 Medicare services across 2,171 unique beneficiaries.
The Data Coverage level for Dr. Balbis is High — reflecting how much public federal data is available about this provider. This is not a quality rating. Patients are encouraged to use this data as one of several factors when choosing a healthcare provider.
✓ 20 years in practice
▲ Top 10% volume in FL
Florida License Status
FL DOH · MQA1
Active license
None
Board action on record
0
Recent admin complaints
| Profession | License # | Status | Expires | Board Action |
|---|---|---|---|---|
| Osteopathic Physician | 9135 | Clear | March 31, 2028 | — |
Data from Florida Department of Health Medical Quality Assurance.
License records are public under Chapter 119, Florida Statutes.
Verify directly on FL DOH →
Medicare Practice Summary
Medicare Utilization ↗3,308
Medicare services
Top 10% in FL for family medicine
2,171
Unique beneficiaries
$35
Avg. Medicare payment
Medicare patients only (65+ / disabled) · Not a quality rating · How to read this →
~165 Medicare services per year of practice
Top procedures by volume
Ranked by number of services performed for Medicare patients. Avg. submitted charge is what the provider billed; avg. Medicare payment is what CMS paid.
| Procedure | Volume | Avg. paid | Avg. submitted |
|---|---|---|---|
| Office visit, established patient (30-39 min) A follow-up office visit for an existing patient lasting between 30 and 39 minutes. The visit involves medical evaluation and management of the patient's condition. |
617 | $82 | $195 |
| Comprehensive metabolic blood panel A blood test that measures a group of chemicals, including glucose, electrolytes, and kidney and liver function markers. |
380 | $10 | $49 |
| Complete blood count (CBC) with differential An automated laboratory test that measures the levels of red blood cells, white blood cells, and platelets in the blood, including a breakdown of the different types of white blood cells. |
329 | $8 | $25 |
| Lipid panel (cholesterol and triglycerides) A blood test that measures cholesterol and triglyceride levels. |
327 | $13 | $75 |
| Hemoglobin A1c test (diabetes monitoring) A blood test that measures your average blood sugar levels over the past two to three months. |
218 | $9 | $54 |
| Thyroid stimulating hormone (TSH) test A blood test that measures the level of thyroid stimulating hormone to evaluate thyroid function. |
190 | $16 | $94 |
| Urine microalbumin test (kidney screening) A laboratory test that measures the amount of microalbumin, a small protein, in a urine sample. This test is used to detect early signs of kidney damage. |
163 | $6 | $12 |
| Creatinine test (kidney function) A blood test that measures the amount of creatinine to assess kidney function or detect muscle injury. |
161 | $5 | $30 |
| Vitamin D level test A blood test to measure the amount of Vitamin D-3 in your body. |
143 | $29 | $79 |
| Hospital follow-up visit, high complexity Subsequent hospital inpatient or observation care for an existing patient involving high-level medical decision making, with at least 50 minutes total time on the date of the encounter. |
101 | $96 | $156 |
| Office visit, established patient (20-29 min) An office visit for an existing patient lasting between 20 and 29 minutes. The visit involves medical evaluation and management of the patient's condition. |
89 | $52 | $138 |
| Vitamin B-12 level test A blood test that measures the amount of vitamin B-12 in your body. |
75 | $15 | $84 |
| Flu vaccine administration This procedure involves the administration of the influenza virus vaccine. It covers the process of delivering the vaccine to the patient. |
73 | $29 | $30 |
| Flu vaccine, high-dose High-dose seasonal influenza vaccine for adults aged 65 and older. Contains four times the antigen of standard-dose flu vaccines (60 mcg per strain), split-virus formulation, preservative-free, single-dose syringe. |
68 | $71 | $80 |
| Folic acid level test A blood test that measures the amount of folic acid in the serum. |
62 | $14 | $47 |
| Blood draw (venipuncture) Insertion of a needle into a vein to collect a blood sample. |
51 | $8 | $15 |
| Office visit, established patient, complex (40-54 min) An office or outpatient visit for an existing patient lasting between 40 and 54 minutes. This level of service is determined by the total time spent on the date of the encounter. |
44 | $128 | $273 |
| Free thyroxine (T4) test A blood test that measures the level of free thyroxine, a thyroid hormone, in the bloodstream. |
30 | $9 | $65 |
| Annual wellness visit, follow-up A follow-up annual wellness visit that includes a personalized prevention plan of service. |
28 | $128 | $198 |
| PSA test (prostate cancer screening) A blood test that measures the level of prostate-specific antigen to screen for prostate cancer. |
22 | $18 | $50 |
| CT scan of chest, without contrast A computed tomography scan of the chest area that uses X-rays to create detailed images without the use of contrast dye. |
19 | $104 | $428 |
| Home health plan of care certification Certification by a physician or allowed practitioner for Medicare-covered home health services under a home health plan of care. This includes contacting the home health agency and reviewing reports of patient status required by physicians. |
17 | $41 | $85 |
| Transitional care management, high complexity Coordination of care for a patient transitioning from a short-term hospital stay or other facility to home or another care setting. This service addresses a high-complexity medical problem. |
15 | $207 | $415 |
| Free T3 thyroid hormone test A blood test that measures the level of free triiodothyronine (T3) hormone in your body. This helps assess how well your thyroid gland is functioning. |
14 | $17 | $88 |
| Vaccine administration The process of giving a vaccine to a patient. This code covers the administration service only and does not include the cost of the vaccine itself. |
13 | $10 | $25 |
| New patient office visit (45-59 min) An initial office visit for a new patient lasting between 45 and 59 minutes. This code covers the total time spent by the physician or qualified healthcare professional on the date of the encounter. |
12 | $75 | $254 |
| Initial hospital admission, high complexity Initial hospital inpatient or observation care for a new patient involving high-level medical decision making, with at least 75 minutes total time on the date of the encounter. |
12 | $140 | $302 |
| Pneumonia vaccine administration This procedure involves the injection of a vaccine to protect against pneumococcal disease. It is administered by a healthcare provider. |
12 | $28 | $29 |
| Annual depression screening | 12 | $18 | $28 |
| Quadrivalent influenza vaccine, preservative-free A flu shot containing four strains of the influenza virus, formulated without preservatives, administered in a 0.5 ml dose. |
11 | $18 | $25 |
How to read this data: This reflects Medicare patients only (typically 65+). Payment amounts are what Medicare paid the provider, not your out-of-pocket cost. A higher procedure volume generally indicates more experience with that procedure.
Geographic Context
Family medicine physicians within 10 mi
35
Per 100K population
49.5
County median income
$55,070
Nearest hospital
VA NORTH FLORIDA/SOUTH GEORGIA HEALTHCARE SYSTEM - LAKE CITY
0.0 mi
0.0 mi
Data Sources
| Provider Registry | ✓ NPPES | Weekly updates |
| Medicare Enrollment | ✓ PECOS | Monthly updates |
| Practice Data | ✓ Medicare Util. | Annual (CY lag) |
| Industry Payments | — No payments | N/A |
| Disciplinary History | — Not public | N/A |
This provider has data in 3 of 4 available federal datasets, with a Data Coverage level of High. This measures how much public data is available about a provider — not how good they are. How we calculate this →
Summary
Dr. Balbis is a clinical cardiology specialist, with above-average Medicare volume (top 10% in FL), with 20 years of NPI registration.
This summary is auto-generated from federal data. It describes data availability and patterns — not clinical quality. Read our methodology →
Frequently Asked Questions
Is Dr. Balbis experienced with office visit, established patient (30-39 min)?
Based on Medicare claims data, Dr. Balbis performed 617 office visit, established patient (30-39 min) services. Research suggests that higher procedure volume is often associated with better outcomes, particularly for complex procedures. Note that Medicare data only captures patients aged 65 and older, so the total practice volume across all patients is likely higher.
How do Dr. Balbis's costs compare to other family medicine physicians in Lake City?
Dr. Balbis's average Medicare payment per service is $35. Note that these figures represent what Medicare pays, not your out-of-pocket cost, which depends on your specific insurance plan and deductible. Procedure-level data above shows both what was submitted and what Medicare paid for each service type.
What does Data Coverage mean?
Data Coverage (currently High for Dr. Balbis) measures how much public federal data is available about a provider. It is not a quality rating. A "Very High" or "High" level means the provider has data across multiple federal sources (NPPES, PECOS, Medicare Utilization, Open Payments), indicating a long track record of practice, Medicare participation, and industry disclosure. A "Low" or "Moderate" level may simply mean the provider is newer, does not see Medicare patients, or has not received any industry payments — none of which are inherently negative. Read our full methodology →
Is this data up to date?
Each data source has its own update cycle. Provider registry data (NPPES) is updated weekly. Medicare enrollment (PECOS) is updated monthly. Medicare practice data has a ~2 year lag — the most recent available is typically 2 years prior. Industry payment data (Open Payments) is published annually, usually in June, covering the prior calendar year. We display the data date prominently on each section so you always know how current it is. See our data freshness policy →
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About this page
All data on this page is sourced verbatim from public federal records published by the U.S. Centers for Medicare & Medicaid Services (CMS): NPPES ↗, Medicare Provider Utilization ↗, and PECOS. Publication is mandated by the Physician Payments Sunshine Act (§6002 ACA, 42 U.S.C. §1320a-7h) and the Freedom of Information Act.
This page is not medical advice, an endorsement, a recommendation, or a quality rating. The Transparency Score measures data completeness — how much federal information exists for this provider — not clinical performance, patient outcomes, or quality of care. Always verify information directly with the provider and consult a licensed clinician before making medical decisions.
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